System with a reservoir for perfusion management

ABSTRACT

A system for perfusion management that monitors, maintains, diagnoses, or treats perfusion deficiencies.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is related to, claims the earliest availableeffective filing date(s) from (e.g., claims earliest available prioritydates for other than provisional patent applications; claims benefitsunder 35 USC §119(e) for provisional patent applications), andincorporates by reference in its entirety all subject matter of thefollowing listed applications; the present application also claims theearliest available effective filing date(s) from, and also incorporatesby reference in its entirety all subject matter of any and all parent,grandparent, great-grandparent, etc. applications of the followinglisted applications:

1. United States patent application entitled A SYSTEM FOR PERFUSIONMANAGEMENT, naming Lowell L. Wood Jr. as inventor, filed substantiallycontemporaneously and commonly assigned herewith.2. United States patent application entitled A SYSTEM WITH A SENSOR FORPERFUSION MANAGEMENT, naming Lowell L. Wood Jr. as inventor, filedsubstantially contemporaneously and commonly assigned herewith.3. United States patent application entitled A TELESCOPING PERFUSIONMANAGEMENT SYSTEM, naming Lowell L. Wood, Jr. as inventor, filedsubstantially contemporaneously and commonly assigned herewith.

TECHNICAL FIELD

The present application relates, in general, to detection and/ortreatment.

SUMMARY

In one aspect, a system includes but is not limited to: a body portion;at least one extensible finger coupled to said body portion; at leastone reservoir in communication with said extensible finger; and acontrol circuitry coupled to said extensible finger, or said bodyportion. In addition to the foregoing, other system aspects aredescribed in the claims, drawings, and text forming a part of thepresent application.

In one aspect, a method includes but is not limited to: fabricating adevice by forming a cavity for storing a receivable; coupling a flexibleconduit to said cavity, the conduit being configured to extend from saidcavity to a target location in an animal's body; and coupling saidflexible conduit and said cavity to a monitoring system, said monitoringsystem including logic or software configured for directing saidreceivable from said cavity to said target location. In addition to theforegoing, other method aspects are described in the claims, drawings,and text forming a part of the present application.

In another aspect, a method includes but is not limited to: storing areceivable in an implanted storage medium; extending a flexible conduitbetween said storage medium and a target location; and transmitting saidreceivable from said storage medium to said target location. In additionto the foregoing, other method aspects are described in the claims,drawings, and text forming a part of the present application.

In one or more various aspects, related systems include but are notlimited to circuitry and/or programming for effecting theherein-referenced method aspects; the circuitry and/or programming canbe virtually any combination of hardware, software, and/or firmwareconfigured to effect the herein-referenced method aspects depending uponthe design choices of the system designer.

In addition to the foregoing, various other method and or system aspectsare set forth and described in the text (e.g., claims and/or detaileddescription) and/or drawings of the present application.

The foregoing is a summary and thus contains, by necessity;simplifications, generalizations and omissions of detail; consequently,those skilled in the art will appreciate that the summary isillustrative only and is NOT intended to be in any way limiting. Otheraspects, inventive features, and advantages of the devices and/orprocesses described herein, as defined solely by the claims, will becomeapparent in the non-limiting detailed description set forth herein.

BRIEF DESCRIPTION OF THE FIGURES

FIG. 1 is a front-plan view of a device for perfusion management 100.

FIG. 2 is a front-plan view of another aspect of the device forperfusion management 100.

FIG. 3 is an exploded view of an extensible finger 104.

FIG. 4 is a schematic view of the control circuit 110 and devices incommunication with the control circuit 110.

FIG. 5 illustrates an example wherein the device for perfusionmanagement 100 is placed in a selected location in a human body 501.

The use of the same symbols in different drawings typically indicatessimilar or identical items.

DETAILED DESCRIPTION

The present application uses formal outline headings for clarity ofpresentation. However, it is to be understood that the outline headingsare for presentation purposes, and that different types of subjectmatter may be discussed throughout the application (e.g.,device(s)/structure(s) may be described under the process(es)/operationsheading(s) and/or process(es)/operations may be discussed understructure(s)/process(es) headings). Hence, the use of the formal outlineheadings is not intended to be in any way limiting.

1. Perfusion Management Device(s) and/or Process(es).

With reference now to FIG. 1, shown is a front plan view illustrative ofvarious exemplary perfusion management device(s) and/or process(es).Accordingly, the present application first describes certain specificexemplary structures of FIG. 1; thereafter, the present applicationillustrates certain specific exemplary processes. Those having skill inthe art will appreciate that the specific devices and processesdescribed herein are intended as merely illustrative of their moregeneral counterparts.

-   -   A. Structure(s) and or Device(s)

With reference to the figures, and with reference now to FIG. 1, shownis a front-plan view of a device for perfusion management 100. Thedevice for perfusion management 100 includes a body portion 102 fromwhich at least one extensible finger 104 projects. At least onereservoir 106 within the body portion 102 contains a fluid, for example,a fluid for treatment. A controllable valve 108 provides a path throughwhich the fluid may travel to the at least one extensible finger 104. Acontrol circuit 110 provides a control signal that may open or close thecontrol valve 108.

Referring now to FIG. 2, depicted is an aspect of the device forperfusion management 100 which includes a body portion 102 from which aset of extensible fingers projects. In one aspect, at least one of theextensible finger 104 of the set of extensible fingers has a sensor 216at the distal end of the at least one of the extensible finger 104.Additionally, a sense line 214 connects the control circuit 110 to thesensor 216 at the distal end of the extensible finger 104. The controlcircuit 110 may be connected to a sense line 214 that allows it tomonitor the fluid levels within the at least one reservoir 106.

Continuing to refer to FIG. 2, in one aspect, each of the extensiblefinger 104 of the set of extensible fingers is in fluid communicationwith at least one of a respective reservoir 106 filled with a differentfluid for delivery. In another approach, the at least one reservoir 106may be coupled to a mixing chamber where the fluid contents of the atleast one reservoir 106 are present for mixing and the mixed contentsenter the extensible finger 104 for delivery to a selected location. Thechoice of the fluid in the at least one reservoir 106 may depend, forexample, on the purpose of the device, for example, treatment of coloncancer, treatment of breast cancer, or treatment of an arterial disease.The choice of fluid in the reservoir 106 includes, but is not limitedto, for example, a chemical, a chemical compound, a protein, alipoprotein, a glycoprotein, a sugar, a lipid, an antigen, an antibody,a cytokine, a peptide, a neurotransmitter, a hormone, an ion, amessenger a molecule, a nucleic acid, an engineered nucleic acid, anucleic acid vector, a drug, a cell, a cell fragment, a cell organelle,a liposome, a pharmaceutical agent, a biological material, or abiological fraction. The reservoir 106 may also be utilized for storageand disposal of operational fluids. Also, although the exemplaryembodiment described herein focuses primarily on fluid delivery, oneskilled in the art will understand that fluid-like substances, such asgels, and fluidizable substances or non-fluid type substances, such assmall solid particles, may be delivered in accordance with theinvention. It will also be appreciated by those having skill in the artthat the nature of the fluid in the reservoir 206 includes, for example,and is not limited to, a liquid, a solution, a mixture, a gel, acolloid, a colloid of a suitable viscosity, a suspension, an emulsion,or any material of low shear-strength for delivery to a site.

In one aspect one or more fluids are delivered to one or more ofselected locations by the device for perfusion management 100. Theselected location may be, for example, in proximity to or within atumor, a circulatory system, an aorta, a vena cava, a site of therapy,or a site of investigation in an animal.

Continuing to refer to FIG. 2, a pump 218 provides fluid at a controlledflow rate for delivery to a site from the reservoir 106. It will beappreciated by those skilled in the art that the type of pump is notcritical to the invention and may include, for example, a mechanicalpump, a piezoelectric pump, an osmotic pump, a source of pressure, or adevice for maintaining a positive flow of fluid through the device.Additionally, fluid flow may be further modulated with micro valves andself-pressurizing fluidic reservoirs. Moreover, in some applications,the fluid may be delivered without a pump. For example, fluid deliverymay be controlled using a pressurized bladder, controlled dissolution ordilution of a material, a drip or gravity type of approach, or any othersuitable approach to deliver the appropriate amount or an appropriatedelivery-rate of the fluid.

With reference now to FIG. 3, depicted is an exploded view of theextensible finger 104 showing a plurality of telescoping segments 304with the sensor 216 at the distal end of each of the telescopingsegments 304. In one aspect of the invention, the sensor 216 is an arrayof sensors, deployed from one or more portholes, at the distal end ofeach of the telescoping segments 304. In one approach, the portholes aresized and shaped to provide access through which the sensors 216 may bedeployed. The portholes may include seals, stress relief or otherfeatures appropriate for proper mechanical deployment. In one approach,one or more of the portholes can be controllably opened or closed toprovide communication exterior to the extensible finger or main body.The sensor 216 may be retracted within the port hole and deployedthrough the porthole. Where the porthole can be opened and closed, theporthole can close to limit communication and can be opened fordeployment. The array of sensors may include, but is not limited to, forexample, sensors for detecting pressure, temperature, chemical, gas,electrolyte, flow, volume, composition, or concentration. In analternate aspect of the invention, microelectrodes, such as, forexample, solid-state microlectrodes are sensitized with an agent fordetecting a relevant interactor. Examples of the agent include, but arenot limited to, for example, agonists of angiogenesis. The choice ofsensor 216 depends on the physiological variable being monitored,treated, or controlled. The term “physiological variable” refers to anyand all measurements relating to the functioning of a living organismunder normal, sub-normal, or abnormal states.

Continuing to refer to FIG. 3 and referring now to FIG. 4, an operativetool 324 is coupled to the distal most telescoping segment 304, ordeployed from the porthole, or carried by the extensible finger 104,further including a carrying line 334 in communication with the controlcircuit 110. The operative tool 324 includes, but is not limited to, forexample, one or more of a combination of, a tool positioner, an ablationdevice, a laser, a vacuum, a siphon 326, an evacuation device, a fluiddispenser 328, a cauterizer 330, a stent 332, a tissue-liquefyingdevice, or a source of an electric or an electromagnetic charge 422. Thevacuum or the siphon is employed for removing a cell, a mass of cells, atissue, a fluid, a gel, a sample, a debris, a contaminant, or othermaterial for which removal is desired or appropriate. The ablationdevice operates for perturbing or reducing the structural integrity orviability of a cell, a mass of cells, an assembly of biologicalmaterials exhibiting shear strength, or a tissue. The assembly ofbiological materials includes, for example, blood clots, cartilage, orbone. The source of an electric or electromagnetic charge 422 includes,but is not limited to, for example, steady state electric currents,time-varying electric currents, alternating electric currents, radiowaves, microwaves, ultraviolet rays, infra-red rays, optical rays,terahertz beams, and the like.

Continuing to refer to FIG. 3, it will be appreciated by those havingskill in the art that the operative tool 324 may include a set ofdevices having general or “multi-purpose” utility. The operative tool324 may include, but is not limited to, for example, a combination ofthe fluid dispenser 328, the siphon 326, and the ablation device. Inthis example the operative tool combination, for example, delivers thefluid or gel, ablates cells, and removes debris.

Continuing to refer to FIG. 3, the plurality of telescoping segments 304may themselves be hollow forming a conduit for delivery of the fluid toa site, or for housing a circuitry coupling the control circuit 110 tothe operative tool 324, or for housing a mechanism that guides the arm104 or the plurality of telescoping segments 304.

With reference now to FIG. 4, illustrated is a schematic view of thecontrol circuit 110 and devices in communication with the controlcircuit 110. The device for perfusion management 100 shows a datatransmitter 410, and a data receiver 408 coupled to the control circuit110. An antenna 412 may be used for transmitting data to the exteriorwirelessly. The antenna 412 is shown diagrammatically, but may be astructure, such as a strip antenna, that may be integrated in a mannerthat does not impair or significantly perturb system performance. Thecontrol circuit 110 is depicted as having a processor 402 coupled to amemory 404 that provides data storage and retrieval capability, and apower source 406. Feedback circuitry or logic circuitry providescommunication between the control circuit 110 and devices incommunication with it. In some applications, a software programproviding instructions may be stored in the memory 404 to controloperation of the control circuitry or to store data gathered undercontrol of the control circuitry. Additionally, the control circuit 110may have components for system integrated digital data gathering,processing, storage, compression and transmission. These can providedata control capabilities and operation control capabilities. Forexample, the transmission components may communicate through the antenna412 to a person, system, computer, or device exterior to the body. Thiscommunication can allow data gathered by the sensors to be displayed,stored or otherwise processed in the external environment. Additionally,this communication may allow for the processed data or a plurality ofnew data to be received from the exterior by the device for perfusionmanagement 100. Data compression can allow the control circuitry tostore data representing larger amounts of data to be stored in thememory 404 or to be transmitted to the exterior environment in a moreefficient manner.

Continuing to refer to FIG. 4, one or more of the operative tools 324are mounted on an actuator 414 which allows for the independent movementof each tool. Alternatively, one or more operative tools 324 may bemounted as a unit on one actuator 414 and moved as a group, for example,forming an aspirating-dispensing unit. For example, the fluid dispenser328 and the siphon 326 may be mounted together as a group. The actuator414 may be a motor, a piezo electrically driven actuator, amicromechanical or electrical effector, or the like.

Continuing to refer to FIG. 4, the extensible finger 104 may include animaging device deployed from the porthole or from the distal end of theextensible finger 104 or carried by a carrying line 334. The term“imaging device” being used herein to designate in general thosecomponents, circuits, assemblies and sub-assemblies comprisingelectrical, optical, or opto-electronic components. In one aspect, thecontrol circuit 110 is coupled to the imaging device that includes alaser 418, or a source of light or scene-illuminating radiation, coupledto an optical feed line 420 to illuminate an area. A charge coupleddevice is positioned to capture data from the illuminated area andprovides an electronic signal indicative of the area imaged.Conventional circuitry then produces a digital representation that maybe displayed, stored in the memory 404, or otherwise processed. Thedisplayed image may serve, for example, for guiding the extensiblefinger 104 to the selected location or for determining the efficacy of atreatment or a procedure. One skilled in the art will recognize that theimaging device described herein is exemplary of imaging devices and thatother imaging devices, including for example, raster and line-scanningimagers, nonvisible spectral imagers, and fluorescence imagers, may beincluded.

With reference now to FIG. 5, the device for perfusion management 100 isdepicted implanted in an aorta 502 with the extensible finger 104traveling a blood vessel in a human body 501. Additionally, the devicefor perfusion management 100 is configured for full or partial placementin the human body 501. The configuration may incorporate a combinationof the following criteria, including but not limited to, dimensions,composition, shape, power dissipation level, or texture. In one aspect,the body portion 102 is sized for implantation in proximity to the aorta502 or the vena cava and the extensible finger 104 is sized fortraveling a blood vessel in an animal, for example, the human body 501.In this aspect, if the vasculature decreases two-fold, each of thetelescoping segments 304 has about a two-fold decrease in diameter. Thelength of the extensible finger 104, for example, depends upon thedistance between the selected location and the location of the bodyportion 102, and the route traveled by the extensible finger 104 toarrive at the selected location. It will be appreciated by those havingskill in the art that the extensible finger 104 including the one ormore of the operative tools 324 is of a size, dimension or shapeoperable for traveling one or more blood vessel of decreasing orincreasing luminal diameter. It will also be appreciated by those havingskill in the art that the extensible finger 104 and the one or moreoperative tool 324 may pass through the wall of the lumen, ortrans-luminally, to the surrounding tissue for detecting, delivery of atreatment, or for sampling. It will also be appreciated by those havingskill in the art that the trans-luminal mode described is not limited toblood vessels and includes the space or cavity of an organ or structure.

It will also be appreciated by those having skill in the art that thedevice for perfusion management 100 and its components, such as, forexample, the extensible finger 104, the plurality of telescopingsegments 304, or one or more operative tools 324, has a size, dimension,shape, material, and properties of flexion, retraction, and extension toallow for the steering, guiding, or positioning of the components of thedevice for perfusion management 100. For example, the extensible finger104 may need to be steered around an occlusion or a fork in thevasculature. In this example, the extensible finger 104 may need toretracted, repositioned and then extended in a new direction. Extending,retracting or repositioning of the extensible finger 104 may beaccomplished by techniques known in the art, for example, by using aguide wire or a by employing a shape polymer. In another aspect, theextensible finger may be retracted and then “punched through” anocclusion to dislodge it. In this example, lasers, shears, or a drug maybe employed to degrade the occlusion. In this example, subsequent to thedislodgement and degradation of the occlusion, the siphon 326 or anevacuation device is employed to evacuate any debris, before theextensible finger 104 continues traveling the circulatory system. Itwill also be appreciated by those skilled in the art that the device forperfusion management 100 is not restricted to traveling the circulatorysystem but may be implanted in any tissue, such as, for example, nerve,epithelial, dermal, sub-dermal, connective, or muscle tissue.Additionally, the device for perfusion management 100 may be implantedin inter-tissue spaces, or inter-organ spaces, for example, those foundwithin a body cavity.

In one aspect the device for perfusion management 100 includes an arrayof sensors 116 positioned across the plurality of telescoping segments304 for monitoring, tracking, or mapping a gradient of temperature,pressure, flow, or material concentration in one or more locations. Theone or more location may be, for example, a tissue, an artery, or avein. In another aspect the device for perfusion management 100 has anauto-correct feature for correcting a sub-normal or abnormal gradient oftemperature, pressure, flow concentration, or material concentration

The device for perfusion management 100 may be composed of materialsknown in the art, for example, a metal, a ceramic, a glass, a plastic, apolymer, a biologically compatible material, or a combination. Forexample, the device for perfusion management 100 may be made ofhelically-coiled stainless steel wire and coated with a polymer, suchas, Teflon™. In another example, the device for perfusion management 100may be made of helically-coiled stainless steel wire and coated with apolymer and impregnated with one or more of a biological material, forexample, including but not limited to, anti coagulants, or inhibitors.

-   -   B. Operation(s) and/or Process(es)

Those having skill in the art will appreciate that some or all of thecomponents of the device for perfusion management 100 may be presentex-vivo. In one implementation, the device for perfusion management 100is placed in proximity to the location on the animal, for example, thehuman body 501, and the extensible finger 104 directed to the selectedlocation and an effective agent delivered in proximity to the selectedlocation. The extensible finger 104 may be retracted after such adelivery, leaving the device for perfusion management 100 in place atthe location, until time for a future delivery of the effective agent oranother operation. In this implementation, the majority of the devicefor perfusion management 100 is ex vivo while the extensible finger 104alternates between ex vivo and in vivo states.

In another aspect, some or all the components of the device forperfusion management 100 are present in vivo. In one implementation, thedevice for perfusion management 100 is placed in proximity to thelocation within the animal, for example, the human body 501, and theextensible finger 104 directed to a selected location and an effectiveagent delivered in proximity to the selected location. The extensiblefinger 104 may be retracted after such a delivery, leaving the devicefor perfusion management 100 in place at the location, until time for afuture delivery or another operation. In this implementation, themajority of the device for perfusion management 100 is in-vivo while theextensible finger 104 alternates between retracted, partially retractedor unretracted states.

In one implementation, the device for perfusion management 100 isoperable by a person. The person monitors, guides, positions, andperforms other actions/operations or manages a response consistent withthe device for perfusion management 100 being managed by the person. Insuch an implementation a separate display device can present imagery toaid the person. The imagery may be captured as described above withreference to FIG. 4, may be computer generated or may be captured by aseparate imaging device internal to or external to the animal, forexample, the human body 501. Actions may be performed under control ofthe person who may be on site or may be linked from a remote location,or the device for perfusion management 100 may be programmed to performsome or all functions automatically. For example, the device forperfusion management 100 may be programmed to perform functions, suchas, lumen clearance, lumen maintenance, monitoring of concentrations,sending of alerts, delivery of one or more of the effective agent attimed intervals or locations, self-check, and self-diagnosis. It will beappreciated by those of skill in the art that the device for perfusionmanagement 100 may be programmed for complete automatic operation of oneor more functions.

-   -   C. Variation(s), and/or Implementation(s)

Those having skill in the art will recognize that the presentapplication teaches modifications of the devices, structures, and/orprocesses within the spirit of the teaching herein. For example, thedevice for perfusion management 100 need not be limited to managingperfusion. The device provides a mechanism for exploring one or moreregions and/or reaching a location within an animal, obtaininginformation, communicating this information, performing operations,performing procedures, and providing treatment. In another example, thedevice for perfusion management 100 may find utility in the managementof physiological functions, the detection or elimination of pathologicalfunctions or conditions, and/or treatment of diseases of non-humananimals. Other modifications of the subject matter herein will beappreciated by one of skill in the art in light of the teachings herein.

The foregoing described aspects depict different components containedwithin, or connected with, different other components. It is to beunderstood that such depicted architectures are merely exemplary, andthat in fact many other architectures can be implemented which achievethe same functionality. In a conceptual sense, any arrangement ofcomponents to achieve the same functionality is effectively “associated”such that the desired functionality is achieved. Hence, any twocomponents herein combined to achieve a particular functionality can beseen as “associated with” each other such that the desired functionalityis achieved, irrespective of architectures or intermedial components.Likewise, any two components so associated can also be viewed as being“operably connected”, or “operably coupled”, to each other to achievethe desired functionality.

While particular aspects of the present subject matter described hereinhave been shown and described, it will be obvious to those skilled inthe art that, based upon the teachings herein, changes and modificationsmay be made without departing from this subject matter described hereinand its broader aspects and, therefore, the appended claims are toencompass within their scope all such changes and modifications as arewithin the true spirit and scope of this subject matter describedherein. Furthermore, it is to be understood that the invention isdefined solely by the appended claims. It will be understood by thosewithin the art that, in general, terms used herein, and especially inthe appended claims (e.g., bodies of the appended claims) are generallyintended as “open” terms (e.g., the term “including” should beinterpreted as “including but not limited to,” the term “having” shouldbe interpreted as “having at least,” the term “includes” should beinterpreted as “includes but is not limited to,” etc.). It will befurther understood by those within the art that if a specific number ofan introduced claim recitation is intended, such an intent will beexplicitly recited in the claim, and in the absence of such recitationno such intent is present. For example, as an aid to understanding, thefollowing appended claims may contain usage of the introductory phrases“at least one” and “one or more” to introduce claim recitations.However, the use of such phrases should not be construed to imply thatthe introduction of a claim recitation by the indefinite articles “a” or“an” limits any particular claim containing such introduced claimrecitation to inventions containing only one such recitation, even whenthe same claim includes the introductory phrases “one or more” or “atleast one” and indefinite articles such as “a” or “an” (e.g., “a” and/or“an” should typically be interpreted to mean “at least one” or “one ormore”); the same holds true for the use of definite articles used tointroduce claim recitations. In addition, even if a specific number ofan introduced claim recitation is explicitly recited, those skilled inthe art will recognize that such recitation should typically beinterpreted to mean at least the recited number (e.g., the barerecitation of “two recitations,” without other modifiers, typicallymeans at least two recitations, or two or more recitations), etc.

1-65. (canceled)
 66. A method for perfusion management comprising:delivering one or more receivables via one or more conduits; andobtaining data using at least one sensor positioned at one or moreportholes of the one or more conduits.
 67. The method of claim 66,wherein the delivering one or more receivables via one or more conduitscomprises: delivering one or more receivables via one or more flexibleconduits.
 68. The method of claim 66, wherein the delivering one or morereceivables via one or more conduits comprises: delivering one or morereceivables via one or more extensible and/or retractable conduits. 69.The method of claim 66, wherein the delivering one or more receivablesvia one or more conduits comprises: delivering one or more receivablesvia one or more telescopically extensible and/or retractable conduits.70. The method of claim 66, wherein the delivering one or morereceivables via one or more conduits comprises: delivering one or morereceivables via one or more guidable and/or movable conduits.
 71. Themethod of claim 66, wherein the delivering one or more receivables viaone or more conduits comprises: delivering one or more receivables viaone or more programably controllable, guidable, and/or positionableconduits.
 72. The method of claim 66, wherein the delivering one or morereceivables via one or more conduits comprises: delivering one or morereceivables via one or more wirelessly controllable, guidable, and/orpositionable conduits.
 73. The method of claim 66, wherein thedelivering one or more receivables via one or more conduits comprises:delivering one or more receivables via one or more articulatableconduits.
 74. The method of claim 66, wherein the delivering one or morereceivables via one or more conduits comprises: delivering one or morereceivables via one or more pliable ducts.
 75. The method of claim 66,wherein the delivering one or more receivables via one or more conduitscomprises: delivering one or more receivables via one or more conduitscomposed of a plurality of segments.
 76. The method of claim 66, whereinthe delivering one or more receivables via one or more conduitscomprises: delivering one or more receivables via one or more conduitsincluding one or more stent portions.
 77. The method of claim 66,wherein the delivering one or more receivables via one or more conduitscomprises: delivering one or more receivables via one or more diametervarying conduits.
 78. The method of claim 66, wherein the delivering oneor more receivables via one or more conduits comprises: delivering oneor more receivables via two or more conduits.
 79. The method of claim66, wherein the delivering one or more receivables via one or moreconduits comprises: delivering one or more receivables from one or morestorage cavities via one or more conduits.
 80. The method of claim 66,wherein the delivering one or more receivables via one or more conduitscomprises: delivering two or more receivables via one or more conduits.81. The method of claim 66, wherein the delivering one or morereceivables via one or more conduits comprises: delivering one or morefluid receivables via one or more conduits.
 82. The method of claim 66,wherein the delivering one or more receivables via one or more conduitscomprises: delivering one or more receivables from one or more mixingchambers via one or more conduits.
 83. The method of claim 66, whereinthe delivering one or more receivables via one or more conduitscomprises: delivering one or more receivables from one or more remotesources via one or more conduits.
 84. The method of claim 66, whereinthe delivering one or more receivables via one or more conduitscomprises: delivering one or more receivables via one or more conduitsat one or more controlled rates.
 85. The method of claim 66, wherein theobtaining data using at least one sensor positioned at one or moreportholes of the one or more conduits comprises: obtaining data using anarray of sensors positioned at one or more portholes of the one or moreconduits.
 86. The method of claim 66, wherein the obtaining data usingat least one sensor positioned at one or more portholes of the one ormore conduits comprises: obtaining data using an array of sensorspositioned at two or more portholes disposed along a length of the oneor more conduits.
 87. The method of claim 66, wherein the obtaining datausing at least one sensor positioned at one or more portholes of the oneor more conduits comprises: obtaining data using at least one sensorpositioned at one or more removably covered portholes of the one or moreconduits.
 88. The method of claim 66, wherein the obtaining data usingat least one sensor positioned at one or more portholes of the one ormore conduits comprises: obtaining data using at least one imagerpositioned at one or more portholes of the one or more conduits.
 89. Themethod of claim 66, wherein the obtaining data using at least one sensorpositioned at one or more portholes of the one or more conduitscomprises: obtaining data using two or more different sensors positionedat one or more portholes of the one or more conduits.
 90. The method ofclaim 66, wherein the obtaining data using at least one sensorpositioned at one or more portholes of the one or more conduitscomprises: obtaining data including one or more variable gradient mapsusing at least one sensor positioned at one or more portholes of the oneor more conduits.
 91. The method of claim 66, wherein the obtaining datausing at least one sensor positioned at one or more portholes of the oneor more conduits comprises: obtaining data using at least one sensorpositioned at one or more sealed portholes of the one or more conduits.92. The method of claim 66, further comprising: receiving and/ortransmitting data.
 93. The method of claim 66, further comprising:wirelessly receiving and/or transmitting data.
 94. The method of claim66, further comprising: performing one or more operations using one ormore operative tools.
 95. The method of claim 66, further comprising:performing one or more operations using one or more sources of pressure.96. The method of claim 66, further comprising: performing one or moreoperations using one or more chargeable polymers.
 97. The method ofclaim 66, further comprising: performing one or more operations usingelectric charge and/or radiation.
 98. The method of claim 66, whereinthe operations are performable fully in vivo.
 99. A system for perfusionmanagement comprising: circuitry programmed to operate one or moreactuators for delivering one or more receivables via one or moreconduits; and circuitry programmed for obtaining data using at least onesensor positioned at one or more portholes of the one or more conduits.100. The system of claim 99, wherein the circuitry programmed to operateone or more actuators for delivering one or more receivables via one ormore conduits comprises: circuitry programmed to operate one or moreactuators for delivering one or more receivables via one or moreflexible conduits.
 101. The system of claim 99, wherein the circuitryprogrammed to operate one or more actuators for delivering one or morereceivables via one or more conduits comprises: circuitry programmed tooperate one or more actuators for delivering one or more receivables viaone or more extensible and/or retractable conduits.
 102. The system ofclaim 99, wherein circuitry programmed to operate one or more actuatorsfor the delivering one or more receivables via one or more conduitscomprises: circuitry programmed to operate one or more actuators fordelivering one or more receivables via one or more telescopicallyextensible and/or retractable conduits.
 103. The system of claim 99,wherein the circuitry programmed to operate one or more actuators fordelivering one or more receivables via one or more conduits comprises:circuitry programmed to operate one or more actuators for delivering oneor more receivables via one or more guidable and/or movable conduits.104. The system of claim 99, wherein the circuitry programmed to operateone or more actuators for delivering one or more receivables via one ormore conduits comprises: circuitry programmed to operate one or moreactuators for delivering one or more receivables via one or moreprogramably controllable, guidable, and/or positionable conduits. 105.The system of claim 99, wherein the circuitry programmed to operate oneor more actuators for delivering one or more receivables via one or moreconduits comprises: circuitry programmed to operate one or moreactuators for delivering one or more receivables via one or morewirelessly controllable, guidable, and/or positionable conduits. 106.The system of claim 99, wherein the circuitry programmed to operate oneor more actuators for delivering one or more receivables via one or moreconduits comprises: circuitry programmed to operate one or moreactuators for delivering one or more receivables via one or morearticulatable conduits.
 107. The system of claim 99, wherein thecircuitry programmed to operate one or more actuators for delivering oneor more receivables via one or more conduits comprises: circuitryprogrammed to operate one or more actuators for delivering one or morereceivables via one or more pliable ducts.
 108. The system of claim 99,wherein the circuitry programmed to operate one or more actuators fordelivering one or more receivables via one or more conduits comprises:circuitry programmed to operate one or more actuators for delivering oneor more receivables via one or more conduits composed of a plurality ofsegments.
 109. The system of claim 99, wherein the circuitry programmedto operate one or more actuators for delivering one or more receivablesvia one or more conduits comprises: circuitry programmed to operate oneor more actuators for delivering one or more receivables via one or moreconduits including one or more stent portions.
 110. The system of claim99, wherein the circuitry programmed to operate one or more actuatorsfor delivering one or more receivables via one or more conduitscomprises: circuitry programmed to operate one or more actuators fordelivering one or more receivables via one or more diameter varyingconduits.
 111. The system of claim 99, wherein the circuitry programmedto operate one or more actuators for delivering one or more receivablesvia one or more conduits comprises: circuitry programmed to operate oneor more actuators for delivering one or more receivables via two or moreconduits.
 112. The system of claim 99, wherein the circuitry programmedto operate one or more actuators for delivering one or more receivablesvia one or more conduits comprises: circuitry programmed to operate oneor more actuators for delivering one or more receivables from one ormore storage cavities via one or more conduits.
 113. The system of claim99, wherein the circuitry programmed to operate one or more actuatorsfor delivering one or more receivables via one or more conduitscomprises: circuitry programmed to operate one or more actuators fordelivering two or more receivables via one or more conduits.
 114. Thesystem of claim 99, wherein the circuitry programmed to operate one ormore actuators for delivering one or more receivables via one or moreconduits comprises: circuitry programmed to operate one or moreactuators for delivering one or more fluid receivables via one or moreconduits.
 115. The system of claim 99, wherein the circuitry programmedto operate one or more actuators for delivering one or more receivablesvia one or more conduits comprises: circuitry programmed to operate oneor more actuators for delivering one or more receivables from one ormore mixing chambers via one or more conduits.
 116. The system of claim99, wherein the circuitry programmed to operate one or more actuatorsfor delivering one or more receivables via one or more conduitscomprises: circuitry programmed to operate one or more actuators fordelivering one or more receivables from one or more remote sources viaone or more conduits.
 117. The system of claim 99, wherein the circuitryprogrammed to operate one or more actuators for delivering one or morereceivables via one or more conduits comprises: circuitry programmed tooperate one or more actuators for delivering one or more receivables viaone or more conduits at one or more controlled rates.
 118. The system ofclaim 99, wherein the circuitry programmed for obtaining data using atleast one sensor positioned at one or more portholes of the one or moreconduits comprises: circuitry programmed for obtaining data using anarray of sensors positioned at one or more portholes of the one or moreconduits.
 119. The system of claim 99, wherein the circuitry programmedfor obtaining data using at least one sensor positioned at one or moreportholes of the one or more conduits comprises: circuitry programmedfor obtaining data using an array of sensors positioned at two or moreportholes disposed along a length of the one or more conduits.
 120. Thesystem of claim 99, wherein the circuitry programmed for obtaining datausing at least one sensor positioned at one or more portholes of the oneor more conduits comprises: circuitry programmed for obtaining datausing at least one sensor positioned at one or more removably coveredportholes of the one or more conduits.
 121. The system of claim 99,wherein the circuitry programmed for obtaining data using at least onesensor positioned at one or more portholes of the one or more conduitscomprises: circuitry programmed for obtaining data using at least oneimager positioned at one or more portholes of the one or more conduits.122. The system of claim 99, wherein the circuitry programmed forobtaining data using at least one sensor positioned at one or moreportholes of the one or more conduits comprises: circuitry programmedfor obtaining data using two or more different sensors positioned at oneor more portholes of the one or more conduits.
 123. The system of claim99, wherein the circuitry programmed for obtaining data using at leastone sensor positioned at one or more portholes of the one or moreconduits comprises: circuitry programmed for obtaining data includingone or more variable gradient maps using at least one sensor positionedat one or more portholes of the one or more conduits.
 124. The system ofclaim 99, wherein the circuitry programmed for obtaining data using atleast one sensor positioned at one or more portholes of the one or moreconduits comprises: circuitry programmed for obtaining data using atleast one sensor positioned at one or more sealed portholes of the oneor more conduits.
 125. The system of claim 99, further comprising:circuitry programmed for receiving and/or transmitting data.
 126. Thesystem of claim 99, further comprising: circuitry programmed forwirelessly receiving and/or transmitting data.
 127. The system of claim99, further comprising: circuitry programmed to operate one or moreactuators for performing one or more operations using one or moreoperative tools.
 128. The system of claim 99, further comprising:circuitry programmed to operate one or more actuators for performing oneor more operations using one or more sources of pressure.
 129. Thesystem of claim 99, further comprising: circuitry programmed to operateone or more actuators for performing one or more operations using one ormore chargeable polymers.
 130. The system of claim 99, furthercomprising: circuitry programmed to operate one or more actuators forperforming one or more operations using electric charge and/orradiation.
 131. The system of claim 99, wherein the system isimplantable.
 132. Non-transitory computer readable media bearingcomputer executable instructions for facilitating operations comprising:delivering one or more receivables via one or more conduits; andobtaining data using at least one sensor positioned at one or moreportholes of the one or more conduits.
 133. A system for perfusionmanagement comprising: means for delivering one or more receivables viaone or more conduits; and means for obtaining data using at least onesensor positioned at one or more portholes of the one or more conduits.